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The U.S. Supercommittee in Congress fails to reach an agreement to come up with $1.2 trillion in savings to reduce the deficit by the Nov. 23, 2011 deadline. This shifts the focus to the sequester or triggering automatic cuts in Jan. 2013, as mandated in the Congressional deficit reduction deal of August 2, 2011. These automatic cuts would reduce defense spending by 10%, cut social programs without touching Medicaid and Social Security, by 7.8%, and reduce Medicare payments by 2%.

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The 2018 budget deal brings Democrats and Republicans together by increasing defense and domestic spending both by about 10%. Spending caps are to be lifted by $500 billion over 2 years with 60% of this going to defense spending increases to bolster America's defense capabilities. Defense spending is a top priority for Republicans.  For Democrats this means staving off some cuts in Medicaid and Medicare, more college affordability funding, and 4 year extension of the Children's Health Insurance program that had expired, funding community health centers for another 2 years.

This also shows that both sides can reach agreement even with divisive rhetoric and serious differences over policies.

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House Democrats in the U.S. see the Republican health care plan making the same mistakes in 2017 that the Democrats made in 2008. With the passage of the bill in the House of Representatives with a vote margin on May 4, 2017, rushed through in the way the Obama bill was also rushed through, the nation remains as divided as ever on the issue of health care. The Republicans favoring limiting subsidies and cutting Medicaid, and using some of the savings for a tax cut. The Democrats favoring mandated coverage for all and large subsidies to reduce the number of uninsured Americans, with expansion of Medicaid for very low incomes. Democrats in the House say the Republican House bill will result in Republicans losing seats in the House in midterm elections.

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Krugman on tax breaks for large corporations that do not create jobs and large cuts to Medicare and Medicaid.

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Questions remain about how well Mehmet Oz, who had a popular television health show Dr Oz, can deliver on reducing obesity levels, handle the cuts in Medicaid, and tackle the overspending on Medicare Advantage, as head of the Center for Medicare and Medicaid Services, With it's $1.5 trillion budget it is the largest agency in the US government other than Defense. It is also not delivering health results as American health for the dollars spent is failing to deliver, many nations in Asia and Europe have better health with a small fraction of the US cost.

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McCain wants to ke.ep his health care plan "neutral" by paying for his health care plan from cuts in Medicare and Medicaid wasteful spending

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Governor Cuomo's budget for New York in 2011, at $132.9 billion, is 2.7% less than the prior year. Cuts to medicaid and local school aid, each amount to $2.85 billion This helps close roughly half of the budget gap of $10 billion.

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Governor Cuomo's 2011 budget for New York includes year-to-year cuts of $2 billion in spending on healthcare and education. Overall the cuts would reduce year-to-year spending by 2%. For Medicaid and education Cuomo made a deal for a two year appropriation locking in fixed rates of growth, so that budget battles with teachers unions and other interests do not have to be repeated next year.

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Krugman questions the Paul Ryan U.S. budget proposal on several grounds. He says the Ryan proposal depends on projections by the Heritage Foundation for its assumption that the tax cuts would generate higher revenues by creating a booming economy. The Heritage Foundation projection is for revenue increasing by $600 billon over the next 10 years as a result of tax cuts. Krugman cites a different view from the Congressional Budget Office estimate for the Ryan proposal, which shows assumed savings from spending cuts will go not to reduce the deficit but to pay for tax cuts, with bigger deficits in the next decade. He says the spending cuts excluding Social Security, Medicare and Medicaid- but including defense- go down from 12% of GDP in 2011 to 6% of GDP in 2022- meaning that cuts in public services will need to cut to the bone. The Medicare part of Ryan's proposal does not say how spending on medical care will be reduced. The voucher or premium support Ryan envisages is estimated by the Congressional Budget Office to cover only one third of the cost of insurance premiums for Medicare equivalent care by 2030. Krugman cites the Center on Budget and Policy Priorities, which says the Ryan proposal achieves two thirds of its $4 trillion in spending cuts over the next decade by cutting programs that primarily serve low-income Americans. ...

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The failure of the Supercommitte in the U.S. Congress by the Thanksgiving deadline will not have any immediate consequences. This is because automatic spending cuts that are supposed to go into effect if the Supercommitte fails, do not go into effect till Jan 2013. This gives Congress another year in which to come up with necessary deficit savings. This is a major reason the two sides divided on major issues from the extension of Bush tax cuts and tax increases, and facing pressure from their party's interest groups and voter support groups, have no special incentive to reach a compromise. Such a compromise also means politicians taking the political risk of not being reelected. Another dynamic that is in play in November 2011 is that interest groups in the Republican and Democratic parties both now see the "sequester," as the automatic cuts are described, as a better alternative than any bipartisan agreement that cuts health and retirement programs. For anti-tax groups, the automatic cuts are better than a deal than includes tax increases. Sen. Rand Paul (R-Kentucky) says: "We promised tax cuts. And I think we need to have cuts." For liberal groups, the trigger or sequester for the 2013 automatic cuts is better than a deal that cuts health and retirement programs. The trigger for automatic cuts will cut agency budgets, but spending for the poor and the elderly -including food stamps, Medicaid, Medicare- is exempted. Eric Kinson, co-director of the Strengthen Social Security Campaign, says no deal is better than one that is flawed, the extra time gives the country time to pause and think about the alternatives....

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The structure of the deal that is coming up for a vote in Congress on August 1st, a day before the August 2 deadline. A deal put together mainly by Senate minority leader Mitch McConnell and Vice President Biden after other deals failed. It gives the government $400 billion immediately and another $500 billion in the fall for raising the debt ceiling. Another 1.2 trillion will be added in 2012. The entire burden for raising it falls on Obama. Obama will be able to get the debt ceiling raised without another long struggle before 2012 elections. On spending cuts- agency spending will be cut by $900 billion over the next 10 years. A new legislative committe will be set up to come up with $1.2 trillion in additional savings by the end of 2012. The mechanism that would force the committe to act or make sure spending cuts were taken if the committee failed, was set up as one in which the trigger is to force automatic across the board cuts. The automatic across the board cuts would be for $1.2 trillion to agency budgets for the next 10 years, and split this half and half between domestic programs and defence. Programs aiding the poor including Medicaid and Social Security would be exempted, but Medicare payments to providers could be touched. No new taxes are part of this deal....

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This Washington Post analysis of the Republican tax bill gives an exceptional view of the bill's impact and provisions. This is the first major change to the tax laws since 1986. The size of the bill is $1.5 trillion, with the Joint Committe on Taxation projection that the bill will increase tax revenues over a decade by $500 billion, meaning that it will cost $1 trillion being added to the deficit. What the bill does: 1. It offers a permanent tax cut to corporations by reducing the corporate tax rate to 21 percent from 35 percent. Industries benefiting the most are mining, real estate, technology, manufacturing. 2. The individual tax cuts expire in 2025. They are skewed to disproportionately help highest income Americans, much less lower income Americans and much more highest income Americans compared to high income Americans. In this sense it is skewed in a an unusual way to the highest earning Americans- a sort of Trump effect in place. The top 1% get a tax break of $51,140 in 2019, middle income people earning about $100,000 get about $1000 a year in 2019, tax payers earning around $50,000 about $380, and those earning less than $25,000 about $60 a year in 2019. Taxpayers earning about 150,000 get about $2000 a year tax cut. (Tax Policy Center) 3. The basic assumption is that tax cuts are revenue neutral if there is economic growth and most of that growth comes from corporations investing in growth. The problem as Greg Ip points out in the Wall Street Journal is that countries trying thsi approach in the past such as Britain have not seen such growth materialize. Corporate profits are the highest in 15 years as percentage of GDP, according to Vanguard founder Bogle, and are now 20% of GDP compared 11% in 1980. If corporations did not invest with this level of profits how much additional investment is going to happen, ask critics, especially as demand drives growth and wages are not boosted under this plan.  4.  Because the bill's changes to current law makes it likely that 13 million less Americans will be insured over a decade- from fewer people signing up for Medicaid and on exchanges for Affordable Care Act- it will hurt lower income Americans. Skewing at both ends of the income spectrum of this type is rare in American history particularly in the twentieth century after the Depression of the 1930's, and poses risks for social cohesion, making it unpopular with most Americans. A CBS News poll taken Dec 3-5 shows 53% of all Americans opposed, only 35% support the tax bill just passed in Congress.  5. Then why did Republicans do this? Republicans needed a legislative success after failure to repeal the Obama Affordable Care law. This pressure led to passage with Republicans probably aware that this is temporary tax reform requiring a real effort by both parties working together after the midterm elections in 2018 and as the presidential election approaches in 2019.    ...

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The Obama administration's proposed budget for fiscal 2013- for the year beginning Oct. 1, 2012- shows the budget deficit for the year at over $1 trillion. It shows new revenue of $1.7 trillion over 10 years mostly from ending the Bush period tax cuts on families earning more than $250,000 a year, restoring the estate tax to the 2009 level and limiting subsidies for oil and gas companies. It proposes raising the tax rate on dividends from 15% to as much as 39.6%, for households earning more than $250,000 a year. This measure is expected to generate $206 billion over 10 years. The budget also offers "principles" for future tax reform by proposing the Buffett rule replace the Alternative Minimum Tax (AMT). The AMT was not indexed for inflation so it has the weakness of putting more middle class taxpayers into AMT, leading to temporary solutions by Congress. The Buffett rule would have people earning more than $1 million pay a tax rate of at least 30%. Many wealthy Americans like Mitt Romney paid lower taxes using deductions to lower tax rates- Romney's tax disclosures show he paid effective tax rate of 14%. The White House says the budget will reduce the deficit by $3 trillion over 10 years through the new taxes, and small changes to Medicare and Medicaid and other spending cuts. This is in addition to the $1 trillion in spending cuts agreed to in a deficit reduction agreement in 2011 between Democrats and Republicans in Congress. The budget proposal proposes investment in education and transportation projects of $137 billion, and continuing through Dec. 2012, a tax break for businesses to increase investment. It includes mandatory spending of $2.7 billion for new community college programs, $6 billion to modernize schools, and $1.8 billion to make homes more energy efficient. It also increases the resources of the Securities and Exchange Commission and the CFTC (two agencies overseeing the banks), $26 million for a new Interagency Trade Enforcement Center to counter unfair trade practices, and cuts U.S. postal delivery to 5 days a week. The result is a program designed to be balanced in terms of economic fairness, making modest investments in the future for education and energy, continuing policies to stimulate growth, and extending the date for bringing the deficit under control to 2018 instead of 2014 as planned earlier....

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This report in the WSJ by Peterson and Hackman shows how the American Health Care Act proposed by Speaker Paul Ryan provides less financial support and allows premiums to go higher for seniors approaching retirement in the 50-64 year age group. Premiums are allowed to go up 5 times that of premiums of young people in the Ryan House  plan compared to 3 times in the Affordable Care Act. Subsidies in the form of tax incentives provide $2000 to younger people going up by age not income to $4000 in the Ryan House plan. By contrast someone 60 years old making $20,000 a year can get Affordable Care Act credit of $9874, and making $40,000 a credit of $6752, according to analysis by Kaiser Family Foundation. The Ryan plan makes health care costs lower for young people in an effort to bring more young people who use less services into the system to support its overall financial condition. Another feature of the Ryan Plan is that it allows only for CPI index +1% even if health care costs are rising faster. Deep cuts to Medicaid affect lower income seniors on Medicare. As a result the AARP organization representing seniors has come out in opposition to the Ryan bill. The GOP plan wants to reduce premium costs yet in the process it makes vulnerable seniors with lower incomes pay more, which is likely to hurt Republicans who won by winning a large part of the senior vote. ...

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With government spending currently at 24% of GDP, the budget proposed by Paul Ryan, chairman of the House Budget Commttee, proposes to bring this down to 22.5% in 2012, and to 20% by 2018. The Ryan proposal would cut spending by $5.8 trillion for 2011-2021, with spending $6.2 trillion less than proposed by the Obama administration. It is a bold effort by House Republicans to bring the deficits down from the $1 trillion plus levels of the last 3 years. Major changes are made under this proposal to Medicare, and Medicaid. People who retire after 2021, would choose from an array of private insurance programs, and the federal government would help pay the premium. Medicare under this arrangement would be a "premium support" system. Medicaid would become a block grant for the states. This proposal estimates a saving of $771 billion on Medicaid over 10 years. The Food Stamp program would also become a block grant system. In addition to this the top individual and corporate tax rates would be 25% instead of 25%, with the changes being revenue neutral as a series of tax breaks would be eliminated....

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Former Louisiana fovernor Bobby Jindal comes under severe criticism from the Washington Post for policies it says hurt the poor by turning down federal Medicaid funds under Obamacare, for using rainy day funds, and cutting spending on education and other needed programs in the state. It says Jindal pursued Grover Norquist's no tax pledge leading to spending cuts in the state and budget gaps, merely to appeal to voters in the GOP presidential primaries. Jindal's appeal to Republican voters actually fell sharply because of unpopular policies and he did not qualify for participation in the presidential televised Republican debates. Republican voters turned to outside candidates such as Trump, Carson and others.

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The Congressional Budget Office's Elmendorf says without spending cuts in payments to doctors and hospitals and other providers, providing coverage to the unisured will put the nation deeper into debt. Popular measures such as increasing preventative care, expanding medical records and rewarding doctors for choosing treatments that improve cost and quality have potential but its not proven how much the savings from this would be. The administration and the White House Budget Director, Peter Orszag, say they are in agreement with the CBO that something needs to be done to seriously reduce costs, reducing payments for Medicare and Medicaid to doctors and hospitals, and making other changes.

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U.S. States faced a shortfall of $86 billion during the 2011 budget season, according to the National Conference of State Legislatures. This was after a rise in tax collections during the last year from an improving economy, and about $30 billion of tax increases passed in 2009 and 2010. States faced the end of $66 billion in federal stimulus aid, and their share of Medicaid costs are expected to go up by $16 billion in this fiscal year, according to the National Association of State Budget Officers. The political mood has shifted with worries about the deficit and fears that tax increases could make the states less attractive for employers. As a result there is a focus on spending cuts with very few tax increases. Forty six states began a new fiscal year this week after legislatures focussed on spending cuts, mostly avoided tax increases, and some states placed restrictions on the pay and benefits of public employees.

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Feldstein says that for the 85% of the people who have healthcare the Obama proposals are not a good deal. The Obama proposals mean higher taxes in the long run to pay for the $1 trillion cost of healthcare for the uninsured group over 10 years. This lower income group has no coverage despite the $300 billion Medicaid program. Feldstein says there surely must be better and less costly ways of getting this lowincome group healthcare. Raising the top income tax rate to 45% from 35%- as a result of letting the Bush tax cuts expire and adding aproposed health surcharge on higher income individuals- would actually lower revenues for the government, as it would change behavior of high income individuals in ways that lower their taxable inome. The result is higher deficits and higher taxes when even without this large deficits are projected for the future. How to slow the rapid growth in healthcare spending? The Obama plan is to cut spending on Medicare. Feldstein sees the govenment's effort aimed at reducing the amount of medical services, as reduced spending comes from fewer services, not reduced payments to providers. Will this result in enough of acost reduction to make the system work. And if the cost reductions are too heavily weighted towards reduced services and not reduced payments to providers would this result in large cuts to services to affect the quality of healthcare for the 85% who are accustomed to a different pattern of healthcare, even though it is structured to allow cost escalation. Feldstein offers no solutions to the problems of cost escalation except to suggest that the Obama plan does not really tackle the cost escalation issues directly with providers, and instead burdens the national finances to an extraordinary degree. And the need for apause and reflection....

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Lawrence Summers, former U.S. Secretary of the Treasury, writes on August 2, the day the debt ceiling deal passed the U.S. Congress. His reaction to the deal is one of relief, cynicism and economic anxiety. Relief that the deal does no immediate damage to the economy, which he says is no small achievement. This comes from not denting the U.S. safety net of Medicaid, Social Security and other social programs in the midst of high unemployment. And raising the debt ceiling through 2012 avoids a repeat of the kind of tense negotiations that took place recently. Cynicism because with the revised information from the Commerce Department of 0.4% growth in the first quarter and 1.4% growth in the second quarter of 2011, the new forecast of U.S. budget deficits would be much higher in the years further out. A mere loss of one half percentage point in the annual rate of growth could add $1 trillion dollars to the national debt in 2021. Summers points out that Congress votes annually on discretionary spending and a current Congress cannot control what a future Congress does. Caps and sequester deals can be reformulated in 2013 by a new Congress. This deal says Summers has only confirmed the lower levels of spending already negotiated for 2011 and 2012, even though the estimates show $1 trillion in deficit reduction. For the remaining $1.2 trillion in reductions to be negotiated by the "super-committee" there is no baseline for these cuts- it is not stated whether this baseline is with the Bush high income tax cuts included or excluded. His economic anxiety comes from the low rate of growth in the first half of 2011 which suggest an economy at close to a standstill. He sees a one in three chance of a U.S. recession in the absence of any efforts to spur growth. Martin Feldstein was quoted on television business channels on August 2, saying he sees a 50% chance of the economy slipping back into a recession. Steps Summers advocates are a non-extension of the Bush high-income tax cuts which would add $1 trillion to deficit reduction, some entitlement reform, extension of the payroll tax cut, extension of unemployment insurance, and infrastructure maintenance....

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Many of the achievements of Jindal in the areas of education, and competitiveness and health care and infrastructure for the state of Louisiana are now at risk because of an anticipated deficit of $2 billion in state revenues for 2009 and in the current year the $865 million surplus has evaporated and turned into a$365 million shortfall all in a short time. The state budget used afigure of $84 abarrrel for oil in calculating the state's revenues related to oil revenues generated in the state from offshore drilling but with oil at $40 a barrel things are not lookin good. The total intake from oil and gas from royalties and leases accounts for 17% of the Louisiana state budget. The state rolled back atax increase and increased expenditures on much needed higher education and health care and infrastructure spending. Louisiana needed these programs because it continues to lose people to migration and is the only southern state to do so. The expected cuts are $109 for education and an additional $160 million for health care cuts much from Medicaid. It also shows how quickly things can change for states that are overdependent on natural resource revenues and in this deep downturn for a range of states from California, to New York to Louisiana....

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In just 7 months the Trump administration has a falling apart with business leaders and union leaders on the days following the Charlottesville car attack. Here Richard Trumka gives his reasons in the NYT for withdrawing from the president's Manufacturing Council. He says Trump presented big idea such as infrastructure and fair trade deals but he is not likely to live up to his promises. Only tweaks are expected on NAFTA says Trumka, and labor rights are taking a hit under president Trump. The AFL-CIO was not called to a single meeting by president Trump, says Trumka. He now sees the Trump administration in the same way as other political leaders- filled with broken promises. In the case of the Trump administration he sees working families ending up much worse off. Trumka says a University of Pennsylvania study shows even if a plan for infrastructure comes up the president's budget proposal would sink it- leading to a net loss of $55 billion for highway, water facilities and public transit. Trumka points out the damage to the social safety net as a matter of serious concern- cutting $1.5 trillion from Medicaid, $59 billion from Medicare, $64 billion from Social Security over 10 years. With cuts to construction workers wages, and a 6% cut for government workers. He calls as "morally bankrupt" and bad economic actions the effort for large scale deportation.  He calls the events in Charlottesville and the president's condoning of the violence in Charlottesville by blaming both sides, the last straw for his union. Separately business leaders resigned from two advisory groups. Chase CEO Dimon pointed out that for economic progress the basic consensus in the country must be preserved, and divisive rhetoric can lead to the unraveling of economic progress- the vital link between society, politics and the economy in line with America's ideals being evident to the business community, as well as to labor. ...

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Allan Blinder gives a spirited account of what he sees in the Paul Ryan Republican deficit reduction plan. He says that with the voucher plan retirees would fall further and further behind the increasing cost of health insurance. With no explicit cost containment proposals it assumes that some kind of miracle will occur for costs to be kept in check- especially as Republicans want to repeal the cost containment proposals in the President's healthcare plan. He asks whether someone is saying, that we have to destroy Medicare so it can be saved. Ryan woulld also turn Medicaid into a block grant, then underfund it and let the states figure it out when they are in a budget squeeze. Blinder points to the estimates of the Center on Budget and Policy Priorities, that show about two-thirds of Ryan's budget cuts would come from programs that serve low and moderate income Americans. And to make matters worse the steep spending cuts go to finance tax cuts that largely benefit the wealthy. He calls this Robin Hood operating in reverse, and coming on top of 30 plus years of rising inequality. David Stockman makes a similiar point on the editorial pages of the New York Times, April 24, 2011; also adding the point that the middle class will have to pay higher taxes for the deficit to be addressed, something President Obama's plan fails to do. Blinder says that the Bowles-Simpson and Rivlin -Domenici proposals attack the deficit reduction problem in a better way, that asks something from all classes and interests. ...

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The major provisions of the Republican House healthcare bill that passed by a vote of 217-213 are- 1. To help people buy insurance coverage the bill offers $2000 to $4000 a year, upto $14,000 a year in credits based mainly on age, reducing them for families making $150,000, individuals making $75,000. 2.  Under the Affordable Care Act insurers cannot charge older Americans more than 3 times for same coverage they offer to younger people, the new bill makes this 5 times. This would increase premiums for older Americans and reduce it for younger Americans. This is the most controversial part of the bill. Older Americans supported the Republican party in the presidential election. 3. The new bill ends Medicaid as an open ended entitlement and places this on a budget with cuts of $880 billion over 10 years. 4. To mollify conservative Republicans a provision allows state to opt out some provisions of the ACA that requires minimum benefits such as maternity care and emergency services. It retains coverage for pre-existing conditions to mollify moderate Republicans. The bill provides states with $138 billion over 10 years to subsidize premiums, provide coverage for pre-existing conditions, mental healthcare and drug addiction. 5. The bill removes the taxes imposed under the Affordable Care Act (ACA) on high income people of about $300 billion over 10 years by repealing a payroll tax increase and tax on investment income. This bill and the ACA offer 2 competing visions on healthcare, both bills passed only by a margin of 4-5 votes in the House. The ACA overlooked the impact on premiums causing discontent among middle income Americans. The new bill lets premiums rise for older Americans in order to keep premiums down for other Americans. This shows the many tradeoffs involved and choices being made, and the lack of a consensus on the issue of healthcare in the U.S., becoming a highly politicized issue instead of the way it is treated in western Europe.     ...

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Senator Mitch McConnell, the Republican Majority leader in the U.S. Senate has come up with a new health care bill that is aimed at winning over reluctant Republican Senators. Two taxes on high income people on 3.8% investment income and a payroll tax of 0.9% on incomes over $200,000 for individuals and $250,000 for couples are retained in this version of the bill, which adds $231 billion over a decade. Some of this is used to offset rising premiums in the new bill, and provide additional funds. The deep cuts to Medicaid are retained and Senator Collins of Maine says she is opposed to the new bill because this will hurt people in rural areas of Maine, and does nothing to change this. Senator Rand Paul of Kentucky is also opposed to the bill. Opposition comes from moderate Senators opposed to deep cuts to Medicaid in Republican health care alternatives to president Obama's Affordable Care Act, and from conservative Senators opposed for other reasons.  Senator Graham of South Carolina and Bill Cassidy of Louisiana introduced their own version just minutes before Mitch McConnell brought up his revised bill. All Democratic Senators are opposed to the Republican bill and call the deep cuts to Medicaid disastrous for lower income people.  ...